Appeals Examiner - West Sacramento, CA (On-site)

Great companies need great teams to propel their operations. Join the group that solves business challenges and enhances the way we work and grow. Working at Gainwell carries its rewards. You’ll have an incredible opportunity to grow your career in a company that values your contributions and puts a premium on work flexibility, learning, and career development. 

Summary

As Appeals Examiner - West Sacramento, CA (On-site) , you can contribute your skills as we harness the power of technology to help our clients improve the health and well-being of the members they serve — a community’s most vulnerable. Connect your passion with purpose, teaming with people who thrive on finding innovative solutions to some of healthcare’s biggest challenges. Here are the details on this position.

Your role in our mission

Help create the power in Gainwell’s processes as we develop purpose-built technologies and solutions that yield better health and human services outcomes.

• Share your expertise as you support the Business Process Services team in claims processing that adheres to policy guidelines 
• Meet production and quality requirements established by clients for timely claims processing 
• Use policy guidelines and criteria established by leadership to evaluate why a claim errored and make an adjudication decision 

What we're looking for

• Knowledge of the fundamental concepts and principles in the medical and/or insurance fields 
• Basic reading and analysis skills to evaluate claims and make adjudication decisions
• Basic computer use skills 
• Ability to multi-task across multiple claims to work efficiently 
• Ability to work independently to meet individual production goals

What you should expect in this role

• Opportunities to travel through your work (0-10%)

The pay range for this position is $37,500.00 - $53,500.00 per year, however, the base pay offered may vary depending on geographic region, internal equity, job-related knowledge, skills, and experience among other factors. Put your passion to work at Gainwell. You’ll have the opportunity to grow your career in a company that values work flexibility, learning, and career development. All salaried, full-time candidates are eligible for our generous, flexible vacation policy, a , and educational assistance. We also have a variety of leadership and technical development academies to help build your skills and capabilities.

We believe nothing is impossible when you bring together people who care deeply about making healthcare work better for everyone. Build your career with Gainwell, an industry leader. You’ll be joining a company where collaboration, innovation, and inclusion fuel our growth. Learn more about Gainwell at our and visit our for all available job role openings.

Gainwell Technologies is an Equal Opportunity Employer, where all qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical condition), age, sexual orientation, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. Gainwell Technologies defines “wages” and “wage rates” to include “all forms of pay, including, but not limited to, salary, overtime pay, bonuses, stock, stock options, profit sharing and bonus plans, life insurance, vacation and holiday pay, cleaning or gasoline allowances, hotel accommodations, reimbursement for travel expenses, and benefits.